MyMedR

Spontaneous lateral pontine hemorrhage with associated trigeminal nerve root hematoma

Veerapen R

Neurosurgery, 1989 Sep;25(3):451-3; discussion 453-4.

Spontaneous hemorrhage into the lateral part of the pons with sequelae compatible with survival has been documented previously. The author describes an unusual case with spontaneous hemorrhage into the lateral pons, with intraneural extension into the right trigeminal nerve root. Radiological features were of an expanding mass of the cerebellopontine angle. The patient was treated surgically with success.

Matched MeSH terms: Pons/surgery*

Meta-analysis of polymorphisms in TPH2 gene and suicidal behavior

Choong MY, Tee SF, Tang PY

Psychiatry Res, 2014 Dec 30;220(3):1163-6.

PMID: 25219619 DOI: 10.1016/j.psychres.2014.07.076

Matched MeSH terms: Pons/metabolism; Pons/pathology

Fulltext Silent lacunar infarct with peduncular hallucinosis

Singh, J., Ahmad, N.

Malaysian Journal of Psychiatry, 2016;25(1):0-0.

MyJurnal

Objective: Lacunar infarct is a small infarct in the distal distribution of deep
penetrating vessels. A silent stroke is not associated with outward symptoms.
The objective of this report is to highlight a case of a silent young stroke
presenting with peduncular hallucinosis.

Methods: This gentleman was
thoroughly investigated and was found to have a lacunar infarct of the Pons
and Occipital Lobe. A further referral to Neurology thereafter; for an in
depth investigation into the cause of this silent young stroke.

Results:
Treatment with low dose antipsychotic resolved the complaints; while the
episode being transient.

Conclusion: Organic psychosis is responsive to
antidopaminergic agents, via action on the Ponto-Geniculo-Occipital
pathways.

Matched MeSH terms: Pons

Fulltext Atypical Clival Chordoma in an Adolescent without Imaging Evidence of Bone Involvement

Hashim H, Rosman AK, Abdul Aziz A, Roqiah AK, Bakar NS

Malays J Med Sci, 2014 Sep-Oct;21(5):78-82.

PMID: 25977639

Clival chordoma is a rare primary bone tumour that arises from the remnant of the notochord and typically occurs in older adults. Upon imaging, the tumour can be seen arising from the clivus and causes clival destruction. This usually provides insight for a diagnosis. Here we present a case of a non-enhancing, pre-pontine mass that was hypointense on T1W and hyperintense on T2W in an adolescent. No clival bone erosion was observed. Based on the age group, imaging findings, and lack of clival erosion, a provisional diagnosis of epidermoid cyst was made and the tumour was resected. This patient was eventually diagnosed with a clival chordoma based on histopathological examination.

Matched MeSH terms: Pons

Fulltext A Hot Cross Bun sign from diffusion tensor imaging and tractography perspective

Loh KB, Rahmat K, Lim SY, Ramli N

Neurol India, 2011 Mar-Apr;59(2):266-9.

PMID: 21483130 DOI: 10.4103/0028-3886.79143

A "Hot Cross Bun" sign on T2-weighted MRI was described as a result of selective loss of myelinated transverse pontocerebellar fibers and neurons in the pontine raphe with preservation of the pontine tegmentum and corticospinal tracts (CST). However, neuropathologic studies showed contradicting results with no sparing of the CST. This is a pictorial and quantitative demonstration of the sign on diffusion tensor imaging and tractography, which provides the imaging evidence that is consistent with neuropathologic findings.

Matched MeSH terms: Pons/pathology*

Fulltext Central pontine and extrapontine myelinolysis: Diffusion weighted imaging and diffusion tensor imaging on follow-up

Nair SR, Ramli NM, Rahmat K, Mei-Ling ST

Neurol India, 2012 Jul-Aug;60(4):426-8.

PMID: 22954982 DOI: 10.4103/0028-3886.100712

Matched MeSH terms: Pons

Fulltext An Englishman with Progressive Deterioration in Cognitive Function

Hamidon, B.B., Sapiah, S.

International Medical Journal Malaysia, 2006;5(1):1-6.

MyJurnal

A 72-year old Englishman was admitted with rapid deterioration in cognitive function, gait disturbance, and cerebellar signs and lapsed into a coma within one week of admission to the hospital. He had long-standing hypertension and hypercholesterolaemia, for which he was on regular medication. He had suffered recurrent episodes of stroke between September 1997 and May 2001. Three months prior to presentation, he became forgetful and generally mentally slow, affecting his daily activities. He was also noted to have fluctuations in his conscious level, associated with myoclonic jerks of the limbs. The brain MRI revealed hyperintense lesions on T2- weighted images in the periventricular region, left corona radiata, centrum semiovale, pons, midbrain and right thalamus. The electroencephalograph revealed periodic sharp wave complexes, strongly suggestive of Creutzfeldt-Jakob disease. However, we were not able to get a tissue diagnosis or send the cerebrospinal fluid for protein 14-3-3.

Matched MeSH terms: Pons

Fulltext Validation Study of Rajasekaran's Kyphosis Classification System: Do We Clearly Understand Single- and Two-Column Deficiencies?

Shetty AP, Rajavelu R, Viswanathan VK, Watanabe K, Chhabra HS, Kanna RM, et al.

Asian Spine J, 2020 Aug;14(4):475-488.

PMID: 32493003 DOI: 10.31616/asj.2020.0014

STUDY DESIGN: Multicenter validation study.

PURPOSE: To evaluate the inter-rater reliability of Rajasekaran's kyphosis classification through a multicenter validation study.

OVERVIEW OF LITERATURE: The classification of kyphosis, developed by Rajasekaran, incorporates factors related to curve characteristics, including column deficiency, disc mobility, curve magnitude, and osteotomy requirements. Although the classification offers significant benefits in determining prognosis and management decisions, it has not been subjected to multicenter validation.

METHODS: A total of 30 sets of images, including plain radiographs, computed tomography scans, and magnetic resonance imaging scans, were randomly selected from our hospital patient database. All patients had undergone deformity correction surgery for kyphosis. Twelve spine surgeons from the Asia-Pacific region (six different countries) independently evaluated and classified the deformity types and proposed their surgical recommendations. This information was then compared with standard deformity classification and surgical recommendations.

RESULTS: The kappa coefficients for the classification were as follows: 0.88 for type 1A, 0.78 for type 1B, 0.50 for type 2B, 0.40 for type 3A, 0.63 for type 3B, and 0.86 for type 3C deformities. The overall kappa coefficient for the classification was 0.68. Regarding the repeatability of osteotomy recommendations, kappa values were the highest for Ponte's (Schwab type 2) osteotomy (kappa 0.8). Kappa values for other osteotomy recommendations were 0.52 for pedicle subtraction/disc-bone osteotomy (Schwab type 3/4), 0.42 for vertebral column resection (VCR, type 5), and 0.30 for multilevel VCRs (type 6).

CONCLUSIONS: Excellent accuracy was found for types 1A, 1B, and 3C deformities (ends of spectrum). There was more variation among surgeons in differentiating between one-column (types 2A and 2B) and two-column (types 3A and 3B) deficiencies, as surgeons often failed to recognize the radiological signs of posterior column failure. This failure to identify column deficiencies can potentially alter kyphosis management. There was excellent consensus among surgeons in the recommendation of type 2 osteotomy; however, some variation was observed in their choice for other osteotomies.

Matched MeSH terms: Pons

Fulltext A rare case of paediatric pontine glioblastoma presenting as a cerebellopontine angle otogenic abscess

Rasalingam K, Abdullah JM, Idris Z, Pal HK, Wahab N, Omar E, et al.

Malays J Med Sci, 2008 Jan;15(1):44-8.

PMID: 22589615

We describe rare case of a 9-year old boy who presented with a two-week history of right ear discharge and mild fever. Contrast enhanced CT scan of the brain showed a lesion in the right cerebellopontine angle with mild enhancement mimicking early abscess formation. Involvement of the mastoid air cells pointing towards a radiological diagnosis of mastoiditis reinforced the diagnosis of an abscess. A magnetic resonance imaging (MRI) was planned for the patient but his conscious level deteriorated and patient slipped into coma warranting immediate surgical intervention. Intraoperatively, about 90% of the tumour was removed and the appearance of the tumour resembled that of an acoustic schwannoma but histopathology confirmed the diagnosis of a glioblastoma multiforme (GBM). MRI done post operatively showed lesion in the pons confirming the diagnosis of an exophytic pontine glioblastoma multiforme.

Matched MeSH terms: Pons

Fulltext Pontine myelinolysis following correction of hyponatraemia

Loo CS, Lim TO, Fan KS, Murad Z, Suleiman AB

Med J Malaysia, 1995 Jun;50(2):180-2.

PMID: 7565192

A patient with severe hyponatreamia secondary to chronic renal failure was treated with peritoneal dialysis (PD). On the third day of admission, she developed progressive obtundation. Neurological examination showed bilateral brisk reflexes with intact brain stem reflexes. Magnetic resonance imaging demonstrated patchy demyelination of the pontine area indicating central pontine myelinolysis (CPM). Despite supportive measures, the patient died on the fifteenth day of admission. The rate of correction of hyponatraemia with peritoneal dialysis can be rapid and detrimental to hyponatraemic chronic renal failure patients and careful monitoring of serum sodium level is advocated.

Matched MeSH terms: Pons/physiopathology*

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